Thoracic Disk Herniation Mimicking Spinal Mass Lesion: An Illustrative Case and Review of the Literature

Abstract

The incidence of intervertebral disk herniation in the thoracic region of the spine is very rare when compared with cervical and lumbar regions. The sequestered disk fragments mimic spinal mass lesions because of lack of noticeable clinical features. The common symptoms are unilateral radicular pain and pain radiating from the upper or middle back to the chest. The differential diagnosis includes not only diverse neoplasms but also other epidural processes such as synovial cysts, hematomas, and inflammatory lesions. Magnetic resonance imaging and computed tomography can be used for diagnosis; however, histologic examination is the exact technique. A variety of surgical approaches have been described to reach these anatomically challenging lesions. We describe a 43-year-old female patient with a sequestrated disk fragment in the thoracic spine that mimics a mass lesion of the spinal canal. We will discuss systematic diagnostic approach, differential diagnosis, and treatment modalities of these lesions.